三叉神经痛患者经皮球囊压迫术术后发生并发症的影响因素及预防分析  

Analysis of influencing factors and prevention strategies of complications after percutaneous balloon compression in patients with trigeminal neuralgia

作　　者：都毅辉 席增辉 王银占 郭文昌 张政浩 钱涛[1] Du Yihui;Xi Zenghui;Wang Yinzhan;Guo Wenchang;Zhang Zhenghao;Qian Tao(Department of Neurosurgery,Hebei Provincial People’s Hospital,Shijiazhuang Hebei 050000,China)

机构地区：[1]河北省人民医院神经外科,河北石家庄050000

出　　处：《中国医刊》2025年第3期269-273,共5页Chinese Journal of Medicine

基　　金：河北省卫生健康委医学科学研究课题计划(20200806)。

摘　　要：目的分析三叉神经痛(TN)患者经皮球囊压迫术(PBC)术后发生并发症的影响因素,并探讨相关预防策略。方法选取2019年5月至2022年5月河北省人民医院收治的152例接受PBC治疗的TN患者为研究对象,根据术后随访期间是否发生相关并发症将研究对象分为并发症组(发生相关并发症,73例)和无并发症组(未发生相关并发症,79例)。比较分析两组患者的临床资料和实验室指标。采用多因素logistic回归方法分析TN患者PBC术后发生并发症的独立影响因素,并构建logistic回归模型。采用受试者操作特征(ROC)曲线分析回归模型对TN患者PBC术后发生并发症的预测价值。采用校准曲线、决策曲线评估回归模型的精确度和临床指导性。结果并发症组患者年龄≥60岁比例、病程≥5年比例、累及V2神经分支比例、合并高血压比例、合并糖尿病比例、球囊持续压迫时间和球囊压力均高于无并发症组,CD4^(+)水平低于无并发症组,差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,年龄≥60岁、累及V2神经分支、合并高血压、合并糖尿病、球囊持续压迫时间≥3.25 min、球囊压力≥131.74 kPa、CD4^(+)<35.23%均为TN患者PBC术后发生并发症的独立危险因素(P<0.05),并以此构建logistic回归模型。ROC曲线分析结果显示,该logistic回归模型预测TN患者PBC术后发生并发症的曲线下面积为0.813(95%CI 0.751~0.875),敏感度为85.6%,特异度为82.4%。校正曲线显示,回归模型的预测概率与实际概率的拟合度较好;决策曲线显示,当回归模型预测概率阈值为0.1~0.9时,其预测TN患者PBC术后发生并发症的净获益最高。结论年龄、累及神经分支、合并高血压、合并糖尿病、球囊持续压迫时间、球囊压力和CD4^(+)均为TN患者PBC术后并发症发生的影响因素,临床可据此采取有效的预防措施,从而显著减少术后并发症的发生。Objective To analyze the influencing factors and prevention strategies of complications after percutaneous balloon compression(PBC)in patients with trigeminal neuralgia(TN).Method A total of 152 TN patients treated with PBC in Hebei Provincial People’s Hospital from May 2019 to May 2022 were selected as the study subjects.According to whether related complications occurred during the postoperative follow-up,they were divided into complication group(related complications occurred,73 cases)and non-complication group(no related complications occurred,79 cases).The clinical data and laboratory indexes in the two groups were compared and analyzed.Multivariate logistic regression method was used to analyze the independent influencing factors of postoperative complications of PBC in TN patients,and the regression model was built.ROC curve was used to analyze the predictive value of regression model for postoperative complications of PBC in TN patients.Calibration curves and decision curves were used to evaluate the accuracy and clinical guidance of regression models.Result The proportion of age≥60 years old,the proportion of disease course≥5 years,the proportion involving V2 nerve branches,the proportion combined with hypertension,the proportion combined with diabetes,the duration of balloon compression and balloon pressure in the complication group were higher than those in the non-complication group,and the CD4^(+)level was lower than that in the non-complication group,with statistical significance(P<0.05).Multivariate logistic regression analysis showed that Age≥60 years old,involvement of V2 nerve branch,combined with hypertension,combined with diabetes,continuous balloon compression time≥3.25 min,balloon pressure≥131.74 kPa,CD4^(+)<35.23%were all independent risk factors for postoperative complications in TN patients(P<0.05),and the logistic regression model was constructed.ROC curve analysis results showed that the area under the curve was 0.813(95%CI 0.751-0.875)of regression model predicted postop

关 键 词：三叉神经痛 经皮球囊压迫术 并发症 影响因素 预防策略 

分 类 号：R745.11[医药卫生—神经病学与精神病学]